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October 6, 1992

TERRY L. ANTHONY, Plaintiff,
Louis W. Sullivan, M.D., Secretary of Health and Human Services, Defendant.


The opinion of the court was delivered by: GLENN E. MENCER



 On November 15, 1988 the plaintiff, Mr. Anthony, applied for disability insurance benefits ("DIB") and Supplemental Security Income ("SSI") under, respectively, Title II and Title XVI of the Social Security Act. See 42 U.S.C.A. ยงยง 401-433, 1381-1383c (West 1991 & 1992). He alleged mental and nervous impairments, later adding that a physical impairment made him unable to work in temperatures exceeding 75 degrees. After initial denial and denial on reconsideration, the claimant requested a hearing. A hearing was held before an Administrative Law Judge ("ALJ") on October 12, 1989, and the ALJ affirmed the denial of the claimant's DIB and SSI benefits in a decision dated December 6, 1989. The Appeals Council denied review on August 9, 1990, and the claimant commenced a civil action in the District Court for the Western District of Pennsylvania.

 After a dispute regarding this court's resumption of jurisdiction was resolved in the plaintiff's favor, on April 4, 1991, we denied both plaintiff's and defendant's motions for summary judgment. Instead, the court entered an Order remanding the case to the Secretary for further proceedings. The remand was made to permit an opportunity for a vocational expert to assess the effect of the claimant's non-exertional limitations upon his potential occupational base.

 A supplemental hearing was held on July 26, 1991, before a second ALJ. The only witnesses were Mr. Anthony and a vocational expert, Mr. William Book. On August 23, 1991, the ALJ issued a decision concluding that Mr. Anthony was not eligible for DIB and not entitled to SSI.


 Mr. Anthony was born on June 23, 1953, and is currently 39 years old. He graduated from high school and then completed a two-year program to attain a commercial and fine arts certificate. Mr. Anthony's marriage ended in divorce more than a decade ago. He has a young child, who lives elsewhere. Prior to his work at Polk State Hospital, Mr. Anthony worked for three months as an orderly at another hospital.

 At Polk State Hospital, he worked for eleven years, from November 4, 1974 to September 28, 1985, as an aide to the mentally retarded. On the job, Mr. Anthony had duties including waking and dressing the mentally retarded, feeding them, taking them on trips and providing other recreation. The job also included some teaching of the mentally retarded and a good deal of paper work.

 Between February 1976 and June 1981, Mr. Anthony was hospitalized for periods of up to several months for mental disturbances. After each hospitalization, he returned to his job at Polk State Hospital. At his initial hearing in 1989, Mr. Anthony explained the circumstances of his departure from Polk State Hospital on September 28, 1985, the date he claims he became unable to work:

 Q: Why did you leave There?

 A: I guess my nerves got to me. You know, I had the breakdown and decided to -- just left because I even called them up and told them I quit. I didn't even go back.

 Q: Well, what symptoms were you having at the time?

 A: Oh, I don't know. I was -- well, I was involved with cocaine and it made me want -- I just didn't care, I guess, anymore about it. And the girl I was seeing out there, she was having a baby at the same time and it had a lot to do with it.

 Mr. Anthony was also drinking an excessive amount of alcohol during that period.

 The record shows that in 1976, the year of Mr. Anthony's first hospitalization, Dr. John Rightor, a general practitioner who has been Mr. Anthony's family physician since 1967, began treating his nervous condition with valium. Mr. Anthony continues to take a daily dose of valium to calm his nerves, however, he has not undergone regular psychiatric or psychological evaluations or counseling since September 1985.

 After leaving Polk State Hospital, he worked for several days as an attendant to an elderly gentleman, who was not satisfied with Mr. Anthony's performance. In 1988, he attended Edinboro University for about a month, working on campus as a painter for eleven hours a week to offset tuition. He left the University because "the pace or something was too fast."

 On September 7, 1989, Dr. Rightor made a note that Mr. Anthony's drug and alcohol use were under control. Mr. Anthony reported that he had stopped using drugs and stopped drinking alcohol because he had "accepted Jesus Christ."

 Recently, Mr. Anthony has lived with his mother. He helps with her five dogs and with chores around the house. He has received welfare benefits and foodstamps. He tends to be reclusive, but attends church regularly and paints pictures as a hobby.


 A review of the medical evidence shows that Mr. Anthony was hospitalized on five occasions between February, 1976, and June, 1981, all for paranoid schizophrenic reactions. His first hospitalization occurred February 8, 1976. On admittance, he was exhibiting marked delusional symptoms and bizarre inappropriate behavior. A psychiatrist, Dr. J.B. Johnston, reported that plaintiff "had many delusions of persecution in which the people at work would be trying to harm him." He felt that people at work were in some way exercising mind-control and trying to influence his decisions. Dr. Johnston noted that Mr. Anthony's psychotic state "could possibly be thought of as drug-induced," but plaintiff denied the use of drugs. He was discharged February 23, 1976.

 Mr. Anthony was hospitalized a second time on March 31, 1976. Dr. Johnston observed that Mr. Anthony was extremely upset and completely inappropriate, was having hallucinations and was extremely bizarre, and had many feelings of persecution, including ideations that his co-workers were trying to harm him. His psychotic condition stabilized with medication, and the patient "went into rather severe depression with marked feelings of worthlessness and hopelessness." Dr. Johnston noted that "there is some question on the part of the family regarding drug involvement but this was never confirmed." Plaintiff was discharged April 21, 1976.

 On September 2, 1979, Mr. Anthony was again admitted to the hospital with bizarre behavior hallucinations, delusions, feelings of persecution, and grandiose feelings. He was discharged on October 3, 1979.

 Mr. Anthony was next brought to the hospital on April 29, 1980, in a state of acute psychosis. Dr. Johnston again reported marked delusions, hallucinations, feelings of persecution and grossly inappropriate conversations. Mr. Anthony was "completely out of contact with his surroundings. He was unable to function in any capacity." He was discharged on June 7, 1980.

 Mr. Anthony's fifth and final psychiatric hospitalization was on June 30, 1981. He was found by police wandering in Clarion, Pa., and was involuntarily admitted to the Oil City Hospital for mental treatment. Hallucinations, delusions of persecution, and bizarre thought patterns were again reported. Dr. Johnston observed that "he continually talked about the powers that were bothering him and the fact that his mind was being controlled." Dr. Johnston also recorded the following:

 This individual has a long history of emotional difficulties, but functions well for periods of time, then for some apparent reasons begins to slip. The hallucinations and delusions reappear; the bizarre thought patterns start to control his actions and he is very noticeable because of his behavior. This results in his being hospitalized.

 Mr. Anthony returned to his job at Polk State Hospital, and worked another four years before leaving for the reasons on which he bases his claim for benefits. Al though he initially denied use of drugs other than marijuana prior to his hospitalizations, Mr. Anthony subsequently has admitted using cocaine and abusing alcohol during ...

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